BILL NUMBER: AB 2185	CHAPTERED  09/07/00

	CHAPTER   325
	FILED WITH SECRETARY OF STATE   SEPTEMBER 7, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 5, 2000
	PASSED THE ASSEMBLY   AUGUST 23, 2000
	PASSED THE SENATE   AUGUST 22, 2000
	AMENDED IN SENATE   AUGUST 10, 2000
	AMENDED IN SENATE   JUNE 21, 2000
	AMENDED IN ASSEMBLY   MAY 24, 2000
	AMENDED IN ASSEMBLY   MAY 3, 2000
	AMENDED IN ASSEMBLY   APRIL 24, 2000

INTRODUCED BY   Assembly Member Gallegos
   (Coauthor:  Assembly Member Hertzberg)

                        FEBRUARY 23, 2000

   An act to add Article 6.4 (commencing with Section 124111) to
Chapter 3 of Part 2 of Division 106 of the Health and Safety Code,
relating to child health.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2185, Gallegos.  Eye pathology screening:  newborns.
   Existing law provides for the newborn and infant hearing
screening, tracking, and intervention program.
   This bill would require the State Department of Health Services,
on or before June 30, 2002, to adopt the protocol developed by the
American Academy of Pediatrics to optimally detect the presence of
treatable causes of blindness in infants by 2 months of age.  If a
protocol is not developed on or before June 30, 2002, the department,
in consultation with representatives of the 11-member Newborn Eye
Pathology Task Force created by the bill, would establish a protocol
to optimally detect the presence of treatable causes of blindness in
infants by 2 months of age on or before January 1, 2003.  The bill
would also provide that if the American Academy of Pediatrics
develops a protocol to optimally detect the presence of treatable
causes of blindness by 2 months of age after the adoption of the
protocol developed by the department, the department would conform
its protocol to the protocol adopted by the American Academy of
Pediatrics.  The bill would specify that any recommended screening
examination would not be conducted on a newborn if a parent or
guardian of the newborn objects to the examination on the grounds
that the examination conflicts with the religious beliefs or
practices of the parent or guardian.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  (a) It is the policy of the State of California to make
every effort to detect pediatric congenital ocular abnormalities
that lead to premature death, blindness, or vision impairment unless
treated soon after birth.
   (b) The Legislature finds and declares all of the following:
   (1) Treatable congenital ocular diseases occur frequently and
require increased early detection efforts.
   (2) Early detection significantly enhances the ability to prevent
serious damage from congenital abnormalities of the eye which, left
undetected and untreated, may result in blinding or life-threatening
diseases, or both.  Examples of such disorders include
retinoblastoma, congenital cataracts, and persistent hyperplastic
primary vitreous.  Other congenital anomalies including colobomas,
vascular retinal anomalies, and congenital retinal folds can be
treated with patching of the good eye to prevent dense amblyopia if
detected early.
   (3) Retinoblastoma is a childhood cancer arising in immature
retinal cells inside the eye and accounts for approximately 13
percent of all cancers in infants; most children are diagnosed before
two and one-half years of age.  When retinoblastoma affects both
eyes, the average age of diagnosis is 12 months.
   (4) Increased emphasis on optimal examination methods, such as
dilation of the eye with eye drops, may facilitate detection of the
abnormal disease process inside the eye of the newborn.  An abnormal
screen will facilitate timely referral to an appropriately licensed
health care provider acting within his or her scope of practice for
diagnosis and to an ophthalmologist for treatment.
   (5) Early detection and referral of an abnormal red reflex
pupillary screen would allow early diagnosis of congenital cataract
or retinoblastoma which, if recognized and treated as soon as
possible after birth, could cause little long-term disability.
   (6) Early diagnosis and intervention can reduce the number of
visually impaired citizens, and reduce the amount of public
expenditures for health care, special education, and related
services.
  SEC. 2.  Article 6.4 (commencing with Section 124111) is added to
Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, to
read:

      Article 6.4.  Newborn Eye Pathology Screening

   124111.  (a) The Newborn Eye Pathology Screening Task Force is
established and shall advise the State Department of Health Services
on the newborn eye pathology screening protocol.
   (b) The task force shall be composed of the following 12 members:

   (1) The Director of Health Services as a nonvoting ex officio
member.
   (2) The 11 voting members shall be appointed by the Director of
Health Services as follows:
   (A) One ophthalmologist with a background in or knowledge of
providing services to infants with retinoblastoma.
   (B) One pediatric ophthalmologist who sees general pediatric
patients and is a designee of the American Association for Pediatric
Ophthalmology and Strabismus.
   (C) One academic pediatrician with a background in or knowledge of
infant eye pathology screening.
   (D) One parent representing families with a child with blindness
or other ocular abnormalities affecting vision.
   (E) One representative from the California Academy of Family
Physicians.
   (F) One representative recommended by the State Department of
Health Services.
   (G) One representative from the American Academy of Pediatrics,
California District.
   (H) One community pediatrician with a background in or experience
with the routine instillation of dilating eye drops as part of red
reflex screening.
   (I) One nurse with a background in or knowledge of the current
department program for the instillation of eye drops to prevent
conjunctivitis.
   (J) One retinal specialist with research experience in detecting
the signs of treatable congenital eye disease.
   (K) One optometrist with a background in or experience with pupil
dilation in infants and red reflex screening for intraocular
pathology.
   (c) Task force members shall serve without compensation, but shall
be reimbursed for necessary travel expenses incurred in the
performance of the duties of the task force.
   124112.  (a) On or before June 30, 2002, the department shall
adopt the protocol developed by the American Academy of Pediatrics to
optimally detect the presence of treatable causes of blindness in
infants by two months of age.  If a protocol is not developed on or
before June 30, 2002, the department, in consultation with
representatives of the Newborn Eye Pathology Task Force, shall
establish a protocol to optimally detect the presence of treatable
causes of blindness in infants by two months of age on or before
January 1, 2003.
   (b) If the American Academy of Pediatrics develops a protocol to
optimally detect the presence of treatable causes of blindness by two
months of age after the adoption of the protocol developed by the
department, the department shall conform its protocol to the protocol
adopted by the American Academy of Pediatrics.
   (c) Nothing in the section shall be construed to supersede the
clinical judgment of the licensed health care provider.
   (d) Any screening examination recommended pursuant to subdivision
(a) shall not be conducted on a newborn if a parent or guardian of
the newborn objects to the examination on the grounds that the
examination conflicts with the religious beliefs or practices of the
parent or guardian.
